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Published on: September 19, 2018
Use Patterns of Novel Janus Kinase Inhibitors After the First Safety Alerts: A Nationwide Register-Based Time Series
Jarno Rutanen1, Pekka Heino2, Kati Sarnola2
1Faculty of Social Sciences, Tampere University, Tampere, Finland.
Pharmacoepidemiology and Drug Safety
|May 19, 2026
Summary
Janus kinase inhibitors (JAKi) use in Finland increased, but declined in inflammatory rheumatic diseases after safety alerts, shifting to younger patients. Conversely, JAKi use steadily rose for inflammatory bowel diseases.
Area of Science:
- Pharmacology
- Rheumatology
- Gastroenterology
Background:
- Janus kinase inhibitors (JAKi) are approved for inflammatory rheumatic musculoskeletal diseases (IRMDs) and inflammatory bowel diseases (IBDs).
- Following marketing authorisation in Europe in 2017, the European Medicines Agency (EMA) issued safety alerts regarding JAKi use.
- Understanding the real-world development of JAKi utilization in Finland is crucial.
Purpose of the Study:
- To analyze the trends in Janus kinase inhibitor (JAKi) initiations and overall use.
- To examine the evolution of JAKi treatment patterns in Finland between 2018 and 2023.
- To assess changes in patient demographics and treatment lines following EMA safety alerts.
Main Methods:
- Retrospective time series analysis of national medicines reimbursement data (2018-2023).
- Inclusion of nearly all JAKi prescriptions for IRMD and IBD treatment.
- Assessment of patient age, line of therapy, and atherosclerotic risk factors.
Main Results:
- JAKi prevalence increased from 0.14 to 0.43/1000 inhabitants overall; IRMD patient use rose from 756 to 1740, and IBD from 11 to 672.
- IRMD JAKi initiations were initially rapid (677 in 2018) but declined (328 in 2023); IBD initiations steadily increased (11 in 2018 to 358 in 2023).
- Mean age of initiating IRMD patients decreased (54 to 41 years), while IBD patients' age slightly decreased (42 to 39 years). Second-line treatment for IRMD decreased from 52% to 31%.
Conclusions:
- JAKi uptake in IRMD was initially fast but declined post-safety alerts, with a shift towards younger patients and fewer risk factors.
- JAKi utilization in IBD demonstrated a consistent upward trend.
- These findings highlight differential adoption patterns of JAK inhibitors in response to safety information and evolving clinical practice.
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